Academic Advancement in Family Medicine: Lessons Learned and Institutional Guidelines Kurt B. Angstman, MS MD, Associate Professor John M. Wilkinson, MD, Assistant Professor Department of Family Medicine, Mayo Clinic Rochester, MN STFM Annual Spring Conference April 26, 2012

Conflict of Interest We have no conflicts of interest to report

Introduction Background on institutional guidelines Instructor/ Assistant Professor/ Associate Professor/ Professor Examples of institutional differences Clinical/ educational tracks Departmental Academic development/promotion Development of your academic advancement What How

Academic Rank Instructor – a promising beginning Assistant Professor – educational achievements: publications and/or “educational efforts” Associate Professor – national reputation, significant publications, effective teacher, institutional leader Professor – continuity of outstanding achievement and focus

Instructor of Family Medicine Academic promise in education, research, or practice Collaborate and find mentors Show interest and capability as a teacher (precepting, curriculum or course development) Show interest and capability as a researcher (collaboration and publications)

Assistant Professor of Family Medicine Significant “educational achievements” and competence in either (or both): a) collaborative or independent publications or... b) sustained and significant educational efforts Clearly documented Lectures or curriculum design Teaching Posters or presentations (STFM, state chapter, etc.)

Associate Professor of Family Medicine National reputation acknowledgment as an authority by peers Significant publications principal author or major collaborator Effective teacher Attract and mentor students, residents, and fellows; curriculum design Institutional leader Sustained educational or administrative accomplishments

Professor of Family Medicine Recognized authority of national or international stature Continuity of work producing significant publications Effective and sustained leader in education Innovative and significant contributions to clinical practice Distinguished institutional service and leadership

Scholarship Reconsidered, Scholarship Assessed: Mayo Clinic core business (2011): “Create, collect, and apply integrated knowledge to deliver the best health care, health guidance, and health information” Scholarship of discovery: new knowledge (research) Scholarship of integration: make connections within (and between) disciplines, interpret, new insight research Scholarship of application: service-oriented – engagement, problem solving (more than “doing good” - requires rigor) Scholarship of teaching: sharing of knowledge, new models of teaching

The Care and Feeding of Your CV: Maintain in a standardized format Keep CV up to date Include everything

The All-Important Chair’s Letter: Write your own Make your mother blush (no time for modesty)

Road of Academic Advancement Publications Scholarly activity Teaching Reviewer/ Journal activity Presentations Posters Oral presentations Invited presentations

Road of Academic Advancement Visiting Professorships National and International reputation “What” is it How do you get “it” Planning for your advancement ARC of academic product Study design Publications Presentations

Publications Initially, the number can be daunting First paper can take months, if not over a year (or more) How then are you able to get the volume??

Publications Write about “what you are doing…” Look for projects based on what you know and are conversant in. DON’T re-create the wheel Every new project then requires new literature search and review DON’T initially plan on large, randomized controlled studies. Much simpler to start with chart reviews, database searches, pilot studies DO develop a template

Publications Start small Ask others who are doing projects, papers if you can help- be a co-author Look for mentors DON’T be too choosy with journals Always peer-reviewed Impact factor is important But early in career- becoming experienced in the process is also important. Many, many journals to select from; all looking for content

Publications Plan on “singles” rather than swinging for the fences. One paper can change a career- but more likely you have smaller manuscripts that you keep building upon. Helps drive future direction “Science is not testing a hypothesis and getting a result- science is getting the result and saying “What now can I do with this information- what is the next study.” Sam B. MD/Phd Student at Mayo

Publications All is well, but still how do you get the numbers… Collaborate, collaborate, collaborate Writing groups 5 people Each with an area of expertise Each one is first author on one paper per year The rest then contribute sections In 5 years, this is 25 papers for all You are first author on the papers of your area of expertise

Manuscript timelines Study design Background and Protocol development IRB approval Data collection Analysis Draft development – tracking different drafts Involving co-authors Completing final draft Submission process Peer Review Rewrites and Re-submission Review Page proofs Publication

Manuscript timelines From starting point to actual publication Many times takes six to 12 months or LONGER NEED to have a few manuscripts/research projects that are at different areas on the timeline. For example- after a manuscript is completed and sent for review- this is a great time to start your next project. You know what the results are and this can help move to the next project. If you are not doing the actual data collection- also here is reasonable to start another.

Scholarly Activity Teaching Journal Reviewer Book/Chapter author Usually the easiest to do Make sure to document your roles!! Journal Reviewer Journal are always looking for new reviewers If you submit to a journal- you are then in their potential reviewer pool Experience as a reviewer helps you as an author Book/Chapter author

Presentations Again- start small, start local; gradually increasing size and impact of conferences At national forums Many times initially will be poster presentations Usually there are templates to help design the poster Conceptually, try to “tell your story” in the equivalent of 8- 10 power point slides Will be easier to develop presentations in the future- if you have a consistent track record of presenting and doing well in previous years Abstracts of papers can allow for presentation of ideas, critical discussion, meeting collaborators and improving your reputation through relationships

Presentation Skills Workshops helpful Practice/ Practice/ Practice Stage fright- consider beta blocker KNOW YOUR AUDIENCE Nothing worse than a presentation that is “canned” Always adapt the presentation to the conference needs Please be respectful of time limits

Visiting Professorships Sometimes this is a challenge Connections help- STFM/AAFP/ Department Chair Connections at meetings Don’t be shy- ASK

National and International Reputation Hard to define… but know it when you see it. Components include: Number of publications Variety of journals published in IMPACT factor How often your work is cited and where it is cited Presentations Although presentations don’t count as much as publications for advancement- the variety of conferences and locations does serve as a proxy for your reputation

National and International Reputation Presentations Introduce yourself with your areas of interest and expertise fmdrl.org- downloads show interest in work Visiting Professorships Focus of your work Much harder to develop a reputation if you have 2-3 manuscripts on 10 topics; you would be much better to have 10 manuscripts on a single area Define your area of interest and expertise Also--This can change over time!

VERY IMPORTANT YOU are not an expert in XYZ waiting to advance in academic rank YOU BECOME an expert over time by publications, presentations and reputation Many younger colleagues are stymied as they don’t see themselves as the expert– and they aren’t… yet

“ARC” of academic achievement As you are planning your career- Study design should consider: Background data Possible review manuscript, AAFP, STFM presentation Pilot study Initial project- to work the kinks out Many times information (OR process) is new and unique enough for publication Presentations locally and nationally Posters Main study Original manuscript and presentations Many times can have “side” articles of interest- but divergent enough to warrant a separate manuscript

“ARC” of academic achievement A research proposal should consider future work as you are designing it One project could have 3-4 manuscripts and 4-6 presentations from it That is how to develop focused academic study to warrant a national reputation

Questions?? THANK YOU! Dr. John Wilkinson Dr. Kurt Angstman wilkinson.john@mayo.edu Dr. Kurt Angstman angstman.kurt@mayo.edu Department of Family Medicine Mayo Clinic Rochester MN